ObjectiveTo find out whether there is any difference in the monitoring results of mosq-ovitraps placed in different orientations in multi-storey residential areas, so as to provide a scientific basis for routine and emergency monitoring of Aedes albopictus with mosq-ovitraps in residential areas. MethodsFrom July 6th to October 26th 2023, one mosquito ovitrap was set up in each of the 4 orientations of east, south, west and north around the buildings in a multi-storey residential area in Jinhui Town, Fengxian District, Shanghai. Data was collected and recorded 72 hours after placement. The chi-square test was used to compare the mosquito ovitrap indices (MOIs) of two independent samples, and the Kruskal⁃Wallis H test was used to compare the MOIs of multiple independent samples. ResultsAfter 16 weeks of surveillance, 997 mosquito ovitraps were recovered, of which 211 were positive, with the mosquito ovitrap index (MOI) of 21.16% and the Aedes albopictus density index of 1.03 mosquitoes·ovitrap^-1. The MOIs were higher in September (24.22%) and October (23.96%), and the MOIs in the west, south and north within the two months were all above 20.00%. From July to October, the MOIs in the east, west, south and north were 20.70%, 22.20%, 25.50% and 16.20%, respectively, and the difference in MOIs among the 4 orientations was not statistically significant (χ²=6.647, P=0.084). Stratified analysis by month showed that in August, the south side of the multi-storey residential areas had the highest MOI (31.30%), the north side had the lowest MOI (1.30%), and there was a statistically significant difference in MOI in the east, west, south and north (χ²=25.986, P<0.001). In October, the MOI in the west was the highest (33.30%) and the MOI in the east was the lowest (6.30%), the difference in MOIs of the 4 orientations was statistically significant (χ²=12.007, P=0.007). The MOIs in the south side of the building in the outskirts of the residential area from the 1st week in July to the 4th week in October was lower (19.20%) than that in the south side of the inner building (31.70%), and the difference in MOI was statistically significant (χ²=5.118, P=0.024). ConclusionThe study of MOI in different orientations in a multi-storey residential area is a preliminary exploration based on field work, and the results show that there is a difference in MOIs in different orientations during the peak breeding period of mosquitoes. Further indicators such as temperature, humidity and wind speed in different orientations can be collected to explore the influencing factors of MOIs.

ObjectiveTo construct a group-based trajectory model (GBTM) for early medication adherence check-in, and to analyze the relationship between different trajectories and treatment outcomes in tuberculosis patients using data that were generated from smart tools for monitoring their medication adherence and check-in. MethodsFrom October 1, 2022 to September 30, 2023, a total of 163 pulmonary tuberculosis patients diagnosed in Fengxian District were selected as the study subjects. The GBTM was utilized to analyze the weekly active check-in trajectories of the subjects during the first 4 weeks and establish different trajectory groups. The χ² tests were employed to compare the differences between groups and logistic regression analysis was conducted to explore the relationship between different trajectory groups and treatment outcomes. ResultsA total of four groups were generated by GBTM analyses, of which a low level of punch card was maintained in group A, 6% of the drug users increased rapidly from a low level in group B, 17% of drug users increased gradually from a low level in group C, and 18% of drug users maintained a high level of punch card in group D. The trajectory group was divided into two groups according to homogeneity, namely the low level medication punch card group (group A) and the high level medication punch card group (group B, group C, and group D). The results of multivariate logistic regression analyses revealed that low-level medication check-in (OR=3.250, 95%CI: 1.089‒9.696), increasing age (OR=1.030, 95%CI: 1.004‒1.056), and not undergoing sputum examination at the end of the fifth month (OR=2.746, 95%CI: 1.090‒7.009) were significantly associated with poor treatment outcomes. ConclusionThe medication check-in trajectory of pulmonary tuberculosis patients within the first 4 weeks is correlated with adverse outcomes, or namely consistent low-level medication adherence check-ins are associated with poor treatment outcomes, while high-level medication adherence check-ins are associated with a lower incidence of adverse outcomes.

Objective To explore the effect of community pharmacy outpatient service on patients with type 2 diabetes mellitus. Methods A non-randomized controlled study was conducted, and type 2 diabetes patients managed in the community were divided into an intervention group of 112 cases and a control group of 110 cases. The control group received routine medication guidance during general practice outpatient visits, while the intervention group received comprehensive pharmacy outpatient service intervention based on routine medication guidance in general practice. Follow-up visits were conducted every 3 months. Repeated measurement analysis of variance and multivariate linear regression analysis were used to evaluate the intervention effect of the pharmacy outpatient service. Results Fasting blood glucose and glycosylated hemoglobin levels in the intervention group showed a decreasing trend with the increase of intervention time compared to pre-intervention time （P<0.01）, with increased duration of weekly exercise, decreased staple food intake, increased vegetable intake, and increased medication adherence score （P<0.01）. After adjusting for confounding factors through multivariate linear regression model, pharmacy outpatient intervention was found to be an independent protective factor for fasting blood glucose level （β=−0.891, P<0.01） and glycosylated hemoglobin level （β=−0.760, P<0.01） in the study subjects. Conclusion The community pharmacy outpatient service could enhance the self-management ability of patients with type 2 diabetes mellitus, and effectively improve patients’ fasting blood glucose and glycosylated hemoglobin.

BACKGROUND:Heterotopic ossification is a dynamic growth process.Diverse heterotopic ossification subtypes have diverse etiologies or induction factors,but they exhibit a similar clinical process in the intermediate and later phases of the disease.Acquired heterotopic ossification produced by trauma and other circumstances has a high incidence. OBJECTIVE:To summarize the molecular biological mechanisms linked to the occurrence and progression of acquired heterotopic ossification in recent years. METHODS:The keywords"molecular biology,heterotopic ossification,mechanisms"were searched in CNKI,Wanfang,PubMed,Embase,Web of Science,and Google Scholar databases for articles published from January 2016 to August 2022.Supplementary searches were conducted based on the obtained articles.After the collected literature was screened,131 articles were finally included and summarized. RESULTS AND CONCLUSION:(1)The occurrence and development of acquired heterotopic ossification is a dynamic process with certain concealment,making diagnosis and treatment of the disease difficult.(2)By reviewing relevant literature,it was found that acquired heterotopic ossification involves signaling pathways such as bone morphogenetic protein,transforming growth factor-β,Hedgehog,Wnt,and mTOR,as well as core factors such as Runx-2,vascular endothelial growth factor,hypoxia-inducing factor,fibroblast growth factor,and Sox9.The core mechanism may be the interaction between different signaling pathways,affecting the body's osteoblast precursor cells,osteoblast microenvironment,and related cytokines,thereby affecting the body's bone metabolism and leading to the occurrence of acquired heterotopic ossification.(3)In the future,it is possible to take the heterotopic ossification-related single-cell osteogenic homeostasis as the research direction,take the osteoblast precursor cells-osteogenic microenvironment-signaling pathways and cytokines as the research elements,explore the characteristics of each element under different temporal and spatial conditions,compare the similarities and differences of the osteogenic homeostasis of different types and individuals,observe the regulatory mechanism of the molecular signaling network of heterotopic ossification from a holistic perspective.It is beneficial to the exploration of new methods for the future clinical prevention and treatment of heterotopic ossification.(4)Meanwhile,the treatment methods represented by traditional Chinese medicine and targeted therapy have become research hotspots in recent years.How to link traditional Chinese medicine with the osteogenic homeostasis in the body and combine it with targeted therapy is also one of the future research directions.(5)At present,the research on acquired heterotopic ossification is still limited to basic experimental research and the clinical prevention and treatment methods still have defects such as uncertain efficacy and obvious side effects.The safety and effectiveness of relevant targeted prevention and treatment drugs in clinical application still need to be verified.Future research should focus on clinical prevention and treatment based on basic experimental research combined with the mechanism of occurrence and development.

ObjectiveTo observe the clinical efficacy of Qushi Huayu granules in treating non-alcoholic fatty liver disease （NAFLD） with dampness-heat accumulation. MethodSixty NAFLD patients with the syndrome of dampness-heat accumulation treated in the outpatient and inpatient departments of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from July 2018 to May 2020 were selected according to the diagnostic criteria and inclusion criteria of both traditional Chinese medicine （TCM） and Western medicine. The patients were assigned into a control group and an observation group by a random， controlled， double-blind， and double simulated method. The observation group was treated with Qushi Huayu granules combined with the mimetic agent of Dangfei Liganning capsules， and the control group was treated with Dangfei Liganning capsules combined with the mimetic agent of Qushi Huayu granules. The treatment course of both groups was 24 weeks. The TCM symptom scores， liver imaging parameters ［controlled attenuation parameter （CAP） in Fibroscan and liver-to-spleen ratio in upper abdominal computerized tomography （CT）］， serum levels of alanine aminotransferase （ALT） and γ-glutamyl transpeptidase （γ-GT）， and safety indicators of the two groups were measured. Result① The total response rate in terms of TCM symptoms in the observation group was 89.29% （25/28）， which was higher than that （48.15%， 13/27） in the control group （Z=-3.582，P<0.01）. The total score of the primary and secondary symptoms in both groups of patients declined after treatment （P<0.05）， and the observation group outperformed the control group in decreasing the total score of the main and secondary symptoms as well as the scores of right rib swelling pain， abdominal fullness and distension or pain， sticky stool， and yellow urine （P<0.05）. ② The response rate in terms of Fibroscan CAP of the liver in the observation group was 75.00% （21/28）， which was higher than that （48.15%， 13/27） in the control group （Z=-1.968，P<0.05）. ③ The response rate in terms of the serum enzyme levels in the observation group was 75.00% （21/28）， which was higher than that （44.44%， 12/27） in the control group （Z=-2.018，P<0.05）. The serum levels of ALT and γ-GT in the two groups declined after treatment （P<0.05， P<0.01） and were lower in the observation group than in the control group （P<0.05， P<0.01）. ④ The response rate in terms of liver CT in the observation group was 67.86% （19/28）， which was higher than that （30.77%，8/26） in the control group （Z=-2.507，P<0.05）. ConclusionQushi Huayu granules were safe and effective in the clinical treatment of NAFLD patients with the syndrome of dampness-heat accumulation， which improved the evidence in TCM treatment of NAFLD and was worthy of in-depth clinical research and promotion. Qushi Huayu granules outperformed Dangfei Liganning capsules in terms of TCM symptoms， serum levels of ALT and γ-GT， and liver imaging parameters.

ObjectiveTo analyze the surveillance status of acute respiratory tract infection pathogens in Fengxian District of Shanghai, and to determine the pathogen spectrum and epidemiological characteristics of acute respiratory tract infection in the district. MethodsCase surveillance data from Fengxian Central Hospital were collected through the Shanghai Integrated Surveillance System for Acute Respiratory Infections, and respiratory specimens were collected from the 50^th week of 2022 to the 49^th week of 2023 for nucleic acid detection of 25 pathogens and bacterial culture testing. Case surveillance data from Fengxian Central Hospital were collected through the National Influenza Sentinel Surveillance System, and respiratory specimens were collected for nucleic acid detection of 5 pathogens. ResultsThe percentage seeking for medical visits of influenza-like illness (ILI) and severe acute respiratory infection (SARI) were 4.74% and 0.81%, respectively, with epidemic peaks in winter and spring. A total of 1 610 samples were detected, among which 354 were SARI cases, whose age of P₂₅ and P₇₅ quartiles were 44 years and 71 years, respectively, with a positive detection rate of 48.31%. Among the 1 256 ILI cases, the age of P₂₅ and P₇₅ quartiles were 21 years and 39 years, respectively. The positive detection rate of pathogens was 65.04% in 123 ILI cases under comprehensive surveillance of respiratory tract infection and 66.11% in 1 133 ILI cases under influenza surveillance. The positive rates of influenza andSARS-CoV-2 in SARI samples were 12.99% and 29.66%, respectively. The positive rates of influenza and SARS-CoV-2 in ILI case samples were 33.20% and 31.53%, respectively. Influenza virus concentrated in the winter and spring. The ILI and SARI cases had the highest positivity rates in the 6‒14 years old group and 15‒24 years old group, respectively. ConclusionThe main pathogens of respiratory tract infection in Fengxian District of Shanghai were SARS-CoV-2 and influenza virus. Special efforts should be made to monitor respiratory disease pathogens in the population under 24 years old, and surveillance of SARI cases aged ≥60 years should be strengthened. The influenza virus and SARS-CoV-2 are alternating, which is different from the past and requires a change in the previous prevention and control strategies.

ObjectiveTo explore the relationship between smoking behavior and related factors among the adult residents in Fengxian District,so as to provide an evidence for carrying out tobacco control and other health promotion work. MethodsA multi-stage stratified cluster random sampling method was used to select 2 272 community residents aged between 15 and 69 yeas to carry out the questionnaire survey. ResultsIn 2020, the smoking rate of adult residents in Fengxian District was 23.50%. Smoking behavior was statistically correlated with age, gender, household registration, chronic disease, occupation and educational level. Smoking behavior was inversely correlated with educational level. Smoking rate of male residents was significantly higher than that of female residents, smoking rate of residents with chronic diseases was significantly higher than that of those without suffering from chronic diseases, and smoking rate of permanent registered residents was significantly higher than that of those non-locals. The highest smoking prevalence was among retired and freelancers, followed by staff of government agencies and public institutes, while the lowest was among students, followed by intellectuals. Multivariate logistic regression analysis showed that gender, age and education level were the main factors affecting the smoking prevalence level. ConclusionThe general　smoking rate of adult residents in Fengxian District was higher than the average level in Shanghai but lower than the national level. Male residents aged ≥25 years and with lower education level are the key invention targets for tobacco control.

This study aims to obtain highly sensitive and specific monoclonal antibodies to ribavirin.Ribavirin was coupled with carrier proteins to synthesize artificial complete antigen by glutaralde-hyde method.UV scanning,gel electrophoresis and animal immunization were employed to identify quality of the synthesized artificial complete antigens.The monoclonal antibody was prepared by cell fusion,positive hybridoma screening and induction of ascites in vivo,and the immunological characteristics of monoclonal antibodies were identified.The results showed that RBV was coupled to carrier proteins,and the artificial antigens were prepared successfully.One cell line that can stably secrete monoclonal antibodies against ribavirin was obtained,and the titers of the mono-clonal antibodies secreted by cell line was above 1∶512 000,with IC50 values of 4.74 μg/L.Fur-thermore,there were no cross-reactivity with other antiviral drugs such as amantadine and carrier proteins.In this study,monoclonal antibodies of ribavirin with high sensitivity and specificity was synthesized successfully,which lays a solid foundation for the establishment of immunoassay methods of ribavirin.

Objective:To investigate the application effect of Precede-Proceed model nursing in postoperative anti-osteoporosis treatment of patients with osteoporotic thoracolumbar fracture (OTLF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 168 patients with OTLF admitted to the Second Affiliated Hospital of Soochow University from September 2021 to June 2022, including 32 males and 136 females, aged 56-81 years [(72.0±6.6)years]. The fractured segments were T 1-T 10 in 29 patients, T 11-L 2 in 114 and L 3-L 5 in 25, all of whom were treated with percutaneous kyphoplasty (PKP). The 86 patients admitted from September 2021 to January 2022 were treated with conventional care (conventional nursing group) and the 82 patients admitted from February to June 2022 with Precede-Proceed model care (Precede-Proceed model nursing group). The compliance rates of anti-osteoporosis treatment at 1 and 6 months postoperatively and at the last follow-up were compared between the two groups, mainly including standardized medication, balanced diet, exercise and regular return visit. Chinese Osteoporosis Quality of Life (COQOL) questionnaire, including pain degree, physical function, social interaction ability, psychological and mental function, and total score were assessed before, at 6 months after surgery and at the last follow-up. Bone mineral density was measured preoperatively and at the last follow-up. Recurrence rate was recorded at the last follow-up. Results:All the patients were followed up for 12-16 months [(13.2±1.0)months]. There were 3 patients in the conventional nursing group and 2 in the Precede-Proceed model nursing group who were lost to follow-up. The compliance rates of standardized medication and regular return visit at 1 month after surgery were 97.5% (78/80) and 98.8% (79/80) in the Precede-Proceed model nursing group, which had no significant difference compared with 90.3% (75/83) and 96.4% (80/83) in the conventional nursing group ( P>0.05). The compliance rates of balanced diet and exercise at 1 month after surgery were 92.5% (74/80) and 91.3% (73/80) in the Precede-Proceed model nursing group, which were higher than those in the conventional nursing group [78.3% (65/83) and 73.5% (61/83)] ( P<0.05 or 0.01). The compliance rates of standardized medication, balanced diet, exercise and regular return visit at 6 months after surgery were 86.3% (69/80), 83.8% (67/80), 82.5% (66/80) and 90% (72/80) in the Precede-Proceed model nursing group, which were higher than those in the conventional nursing group [57.8% (48/83), 60.2% (50/83), 38.6% (32/83) and 37.3% (31/83)] ( P<0.01). At the last follow-up, the compliance rates of all the aspects in the Precede-Proceed model nursing group were 80% (64/80), 75% (60/80), 70% (56/80) and 82.5% (66/80), which were all higher than those of the conventional nursing group [36.1% (30/83), 54.2% (45/83), 26.5% (22/83) and 27.7% (23/83)] ( P<0.01). There were no statistical differences in COQOL scores including pain degree, physical function, social interaction ability, psychological and mental function and total scores between the two groups before surgery ( P>0.05). The pain degree, social interaction ability, psychological and mental function and total scores of COQOL in the Precede-Proceed model nursing group were lower than those in conventional nursing group at 6 months after surgery and at the last follow-up ( P<0.05 or 0.01). There was no statistical difference in the physical function of COQOL scores at 6 months after surgery ( P>0.05). The physical function of COQOL scores in the Precede-Proceed model nursing group were significantly lower than that of the conventional nursing group at the last follow-up ( P<0.05). There was no statistical difference in preoperative bone mineral density between the two groups ( P>0.05). Bone mineral density in the Precede-Proceed model nursing group was (-2.7±0.9)SD at the last follow-up, which was higher than that in the conventional nursing group [(-3.1±0.9)SD] ( P<0.05). At the last follow-up, bone mineral density of the Precede-Proceed model nursing group was significantly improved compared with that before surgery ( P<0.01), while there was no significant difference in the conventional nursing group ( P>0.05). The incidence of refracture in the Precede-Proceed model nursing group was 3.8% (3/80), which was lower than that in conventional nursing group [13.3% (11/83)] ( P<0.05). Conclusion:Compared with the conventional nursing mode, the Precede-Proceed model nursing can significantly improve the compliance rate of OTLF patients with postoperative anti osteoporosis treatment, improve their quality of life and bone quality, and reduce the incidence of refracture.

Objective To investigate the experience of intrauterine device(IUD)removal in patients with cervical cancer after radiotherapy.Methods A total of 23 patients with cervical cancer after radiotherapy underwent abdominal ultrasound guided hysteroscopic removal of IUD in our department from January 2020 to December 2022.For vaginal and/or cervical adhesions,blunt separation of adhesions was performed by using hysteroscope head or curved forceps under abdominal ultrasound guidance.If it was difficult to separate the adhesions for hysteroscope head entering the uterine cavity,a probe was inserted into the uterine cavity under ultrasound guidance,and the cervical canal was gradually expanded to 6-caliber dilation rod.Then the hysteroscope was inserted again into the uterine cavity.For obvious cervical atrophy that was tough in which cervical forceps could not be used to clamp the cervix,a 1-0 absorbable suture line was used to suture the anterior and/or posterior lips of the atrophied cervix at the top of the vagina,with an assistant firmly pulling and fixing the cervix.Results There were 4 cases of vaginal partial adhesions and cervical contracture,10 cases of cervical contracture,and remaining 9 cases having no vaginal adhesions and cervical contracture.Under hysteroscopy,there were 3 cases of cervical adhesions,2 cases of endometrial polyps,1 case of submucosal uterine fibroids,2 cases of uterine abscess,2 cases of incarcerated IUD,and remaining 13 cases having normal uterine cavity morphology.All the 23 cases of IUD were successfully removed by using abdominal ultrasound guided hysteroscopy(circular shaped in 12 cases,uterine shaped in 6 cases,V-shaped in 2 cases,Y-shaped in 1 case,T-shaped in 1 case,and umbrella shaped in 1 case).The surgical time was(19.2±10.9)min,and there were no complications such as false passage formation,uterine perforation,organ damage,massive vaginal bleeding,transurethral resection of the prostate syndrome,infection,embolism,or shock.The 23 cases were followed up for 2-24 months postoperatively,with a median of 12 months.One case continued concurrent radiotherapy and chemotherapy,3 cases continued post-loading radiotherapy,1 case continued chemotherapy,and 2 cases received targeted treatment(distant metastasis).The remaining 16 cases recovered well in regular reviews without complications such as abdominal pain,fever,or vaginal bleeding.Conclusions If the size and location of the cancer lesion do not affect the removal of IUD after radiotherapy for cervical cancer,it should be removed as soon as possible.The application of abdominal ultrasound guided hysteroscopy in IUD removal in patients with cervical cancer after radiotherapy is safe and feasible to a certain extent.